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Ann Thorac Surg 2007;83:287-288
© 2007 The Society of Thoracic Surgeons

Case Reports

Successful Aortic Valve Replacement for Heyde Syndrome With Confirmed Hematologic Recovery

Atsutomo Morishima, MD, Akira Marui, MD, PhD, Takeshi Shimamoto, MD, Yoshiaki Saji, MD, Keiichi Tambara, MD, PhD, Takeshi Nishina, MD, PhD, Masashi Komeda, MD, PhD*

Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan

Accepted for publication May 16, 2006.

* Address correspondence to Dr Komeda, Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawara, Sakyo, Kyoto 606-8507 Japan (Email: komelab{at}kuhp.kyoto-u.ac.jp).

Aortic valve stenosis can be complicated by recurrent gastrointestinal bleeding, particularly that due to angiodysplasia, also called Heyde syndrome. Recently, acquired type 2A von Willebrand disease, which is characterized by the loss of the large multimer of von Willebrand factor by the shear stress of aortic valve stenosis, was reported to be associated with this hemorrhagic syndrome. A 78-year-old woman, with severe aortic stenosis, presented with advanced anemia due to recurrent gastrointestinal bleeding and was diagnosed Heyde syndrome. By perioperative supplementation of von Willebrand factor and factor VIII, aortic valve replacement was safely performed without gastrointestinal bleeding. After the operation, the multimer of von Willebrand factor was normalized and thereafter no gastrointestinal bleeding occurred. This case reports the successful aortic valve replacement for Heyde syndrome, with confirmed hematologic recovery.




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